Costing breaks and opportunities

<p>There continues to be a growing demand for information about the costs of and cost-effectiveness of community care services. The demand is for a wide variety of purposes including estimating service prices, costing the effect of demographic changes or new policies, examining the technical efficiency of services over time, and evaluating the cost effectiveness of innovations. Knapp has classified this range of purposes into four broad groups of demand: practice, policy, accountability and research (Knapp, 1995).

<p><p><p>The demand for cost information in the field of services that provide short term care and breaks for carers and users is<p><p>particularly acute as this is an area in which there is generally a dearth of cost information and which is growing rapidly in response to the changed arrangements as a result of the NHS and Community Care Act (1990). It is also an area in which<p><p>traditional approaches to providing breaks are being challenged and innovative approaches are being explored. The practice demands for costs information include the need for an understanding of the costs among those considering providing such services. Those concerned with policy need to set such information in the context of alternative approaches to providing support to users of services and their carers. Those concerned with funding services need an understanding of the costs of provision when evaluating value for money. Those with limited resources considering different approaches need research based information about the comparative cost-effectiveness of different approaches.

<p><p><p>This chapter focuses primarily on the use of costs in a research context and begins by outlining the theoretical background<p><p>and basic principles of costs research using four 'rules' of costing. The implications of these rules are then explored for the<p><p>costing of services which provide breaks for carers and opportunities for users. Elsewhere in this volume the wide variety of services that fall under this umbrella heading has been demonstrated.

<p><p><p>This chapter will focus on services used by adults with learning difficulties drawing in particular on a recent study of<p><p>innovative approaches to providing breaks (Hayes et al., 1995). These services linked users to support workers, carers or<p><p>befrienders for `sessions' which included a wide variety of activities including social occasions, trips out, sport, shopping,<p><p>weekend breaks and overnight stays.